Malabsorption associated with extreme malnutrition: importance of replacing plasma albumin.

Moss, Gerald S.

doi:10.1080/07315724.1982.10718095

Cited by 22 publications

(6 citation statements)

References 9 publications

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“…The l-"C Triolein breath test was used to measure fat absorption. This test whilst being indirect, depending upon collection of breath 14C02 following oral administration of lJ4C Triolein, gives results which agree well with those of fat absorption obtained by faecal fat analysis (Holmes & Hill, 1988) (Newcomer et al, 1979.…”

Section: Introductionsupporting

confidence: 71%

Prospective study of food intake and nutritional status in HIV infection

Foskett

Kapembwa

Sedgwick

et al. 1991

J Human Nutrition Diet

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Weight loss is a common feature of Human Immunodeficiency Virus (HIV) infection. The aetiology of such weight loss is multifactorial; however the relative importance of factors involved is unknown. In order to test the hypothesis that a gross reduction of food intake is one of the factors responsible for weight loss seen in HIV disease, we prospectively measured food intake for 7 days in 11 male HIV antibody positive subjects and nine male control subjects. Anthropometric measurements were taken to assess nutritional status and fat absorption was assessed using 1–14C Triolein breath test. In the 3 months preceding the study mean weight loss was 3.9±1.2 kg. (s.e.m.) for the HIV antibody positive group. Protein and energy intakes were not significantly different between the two groups. HIV infected subjects had significantly lower mid‐arm muscle circumference (MAMC) and grip strength (GS). Fat malabsorption of a minor degree was detected in only three subjects. These data suggest that constitutionally well HIV infected subjects have reduced MAMC and GS in the face of apparently adequate protein and energy intakes.

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Section: Introductionsupporting

confidence: 71%

Prospective study of food intake and nutritional status in HIV infection

Foskett

Kapembwa

Sedgwick

et al. 1991

J Human Nutrition Diet

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“…In 1981, Moss [10] reported a case of an 82-yearold malnourished patient with gastric cancer causing esophageal obstruction and inducing severe dysphagia. Upon initiation of an elemental diet, the patient developed diarrhea within 14 hours.…”

Section: Recent Clinical Studies On the Relation Of Albumin And Intesmentioning

confidence: 99%

“…Some authors have indicated that infusion of albumin could be beneficial in the initial period of total parenteral nutritional support and could also al leviate the early symptoms of intestinal intolerance at the initiation of enterai feeding [7,10,13,14]. The aims of this report are to briefly review the present knowledge on the role of albumin in nutritional sup port of malnourished patients and the effects of hypoalbuminemia and malnutrition on intestinal ab sorption and to delineate what further studies are in dicated.…”

Section: Introductionmentioning

confidence: 95%

“…In recent years, physicians and nutritionists have expressed increasing interest in the role of serum al bumin in evaluating the degree of malnutrition and predicting the response of patients to enterai feeding [1][2][3][4][5][6][7][8][9][10][11][12]. Some authors have indicated that infusion of albumin could be beneficial in the initial period of total parenteral nutritional support and could also al leviate the early symptoms of intestinal intolerance at the initiation of enterai feeding [7,10,13,14].…”

Section: Introductionmentioning

confidence: 99%

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The role of albumin in nutritional support.

Mobarhan

1988

Journal of the American College of Nutrition

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Hypoalbuminemia is considered one of the hallmarks of protein-calorie malnutrition and chronic liver disease. Recently, serum albumin has also been proposed as a critical predictor of the response to nutritional support and tolerance to enteral feeding in critically ill patients. Albumin is essential for maintenance of plasma colloidal osmotic pressure, prevention of edema, and transport of certain drugs and nutrients. Experimental studies have shown that rapid plasma expansion and reduced plasma protein concentration and osmotic pressure induce a net secretion of sodium and water into the small intestinal lumen. However, the effects of chronic hypoalbuminemia per se on intestinal absorption, independent of malnutrition, have not been fully studied. It is documented that both chronic illness and malnutrition may profoundly affect intestinal anatomical structure and function, inducing some degree of malabsorption. In the last few years, some have advocated albumin infusion to improve clinical response to patients with hypoalbuminemia receiving parenteral nutritional support or to reduce intestinal intolerance and diarrhea in patients receiving enteral tube feeding. A review of the literature shows that both clinical and experimental data to support these suggestions are scarce and further investigations are needed. Hypoalbuminemia is one of many parameters of malnutrition, and it is unlikely that correction of a single parameter for a short time would lead to major clinical benefits.

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“…The exact cause of this diarrhea is not known, but many factors have been identified as responsible, including H 2 blockers [2], sepsis [3], for mula osmolarity [4] and fat content [5], antibiotic usage [5,6], and the presence of multiple organ failure [7]. Recently, attention has focused on the role of hypoalbuminemia and the need for supplemental albumin in fusions [8][9][10][11] and for special enterai formulas [12,13].…”

Section: Introductionmentioning

confidence: 99%

Protein and carbohydrate absorptive efficiency of chronically malnourished and well-nourished patients during enteral feeding initiation.

Benya

Zarling²,

Monteagudo³

et al. 1991

Journal of the American College of Nutrition

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To investigate the efficiency of protein and carbohydrate absorption, we studied malnourished and well-nourished subjects during the first 72 hours of tube feeding. We furthermore investigated whether differences in absorptive efficiency existed between malnourished patients with and without nongastrointestinal malignancy. Twenty-one subjects starting tube feeding without edema or major organ failure and not on antibiotics (well-nourished controls = 7; malnourished = 7; malnourished with nongastrointestinal malignancy = 7) received 50 kcal/hr Osmolite continuously for 72 hours. Twelve of these subjects completed an additional 48 hours of study where they received 125 kcal/hr continuously. We performed hydrogen breath tests to assess carbohydrate absorption and determined stool nitrogen content to assess protein absorption. We also measured frequency of defecation, stool weight, and stool moisture content. The results of these tests failed to reveal statistically significant differences between the three groups in terms of protein and carbohydrate absorption, as well as failed to demonstrate the presence of diarrhea. We conclude that patients receiving an isoosmolar diet who are malnourished, or malnourished with nongastrointestinal malignancy, absorb carbohydrate and protein as well as well-nourished patients during enteral hyperalimentation.

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Malabsorption associated with extreme malnutrition: importance of replacing plasma albumin.

Cited by 22 publications

References 9 publications

Prospective study of food intake and nutritional status in HIV infection

Prospective study of food intake and nutritional status in HIV infection

The role of albumin in nutritional support.

Protein and carbohydrate absorptive efficiency of chronically malnourished and well-nourished patients during enteral feeding initiation.

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